The safety and immunogenicity of trivalent inactivated influenza vaccination: a study of maternal-cord blood pairs in Taiwan

Shin-Yu Lin, En-Tzu Wu, Chia-Hui Lin, Ming-Kwang Shyu, Chien-Nan Lee, Shin-Yu Lin, En-Tzu Wu, Chia-Hui Lin, Ming-Kwang Shyu, Chien-Nan Lee

Abstract

Background: There are little data about adverse effects and immunogenicity of flu vaccine in Asian pregnant women.

Methods: This prospective trial (NCT01514708) enrolled 46 pregnant women who received a single intramuscular dose of trivalent flu vaccine (AdimFlu-S®) containing 15 mcg of hemagglutinin for each strain/0.5 mL from influenza A (H1N1), influenza A (H3N2), and influenza B after the first trimester. Blood samples were collected at day 0 and 28 after vaccination, and at delivery. Cord blood was also collected. Hemagglutination inhibition (HAI) assays were performed to determine seroprotection and seroconversion rates and fold increase in the HAI geometric mean titer (GMT).

Results: Twenty-eight days after vaccination the seroprotection rate against H1N1, H3N2, and influenza B was 91.3%, 84.8% and 56.5%, respectively. The GMT fold increase was 12.8, 8.4, and 4.6 for H1N1, H3N2, and influenza B, respectively. At delivery, both the seroprotection rate (86.4%, 68.2%, and 47.7%) and GMT fold increase (9.4, 5.7 and 3.8) were slightly lower than day 28. The seroprotection rate and GMT fold increase in maternal and cord blood samples were comparable. No significant adverse effects were detected.

Conclusions: Trivalent flu vaccine induces a strong immune response in pregnant women and their infants without adverse effects.

Trial registration: Clinical Trials. gov NCT01514708.

Conflict of interest statement

Competing Interests: This study was funded by Adimmune Corporation. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1. The trial profiles.
Figure 1. The trial profiles.

References

    1. Bhat N, Wright JG, Broder KR, Murray EL, Greenberg ME, et al. (2005) Influenza-associated deaths among children in the United States, 2003–2004. N Engl J Med 353: 2559–2567.
    1. Mak TK, Mangtani P, Leese J, Watson JM, Pfeifer D (2008) Influenza vaccination in pregnancy: current evidence and selected national policies. Lancet Infect Dis 8: 44–52.
    1. Cox S, Posner SF, McPheeters M, Jamieson DJ, Kourtis AP, et al. (2006) Hospitalizations with respiratory illness among pregnant women during influenza season. Obstet Gynecol 107: 1315–1322.
    1. Neuzil KM, Reed GW, Mitchel EF, Simonsen L, Griffin MR (1998) Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women. Am J Epidemiol 148: 1094–1102.
    1. Hartert TV, Neuzil KM, Shintani AK, Mitchel EF Jr, Snowden MS, et al. (2003) Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. Am J Obstet Gynecol 189: 1705–1712.
    1. Neuzil KM, Mellen BG, Wright PF, Mitchel EF Jr, Griffin MR (2000) The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. N Engl J Med 342: 225–231.
    1. Gall SA, Poland GA (2011) A maternal immunization program (MIP): developing a schedule and platform for routine immunization during pregnancy. Vaccine 29: 9411–9413.
    1. Poehling KA, Szilagyi PG, Staat MA, Snively BM, Payne DC, et al. (2011) Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol 204: S141–148.
    1. Eick AA, Uyeki TM, Klimov A, Hall H, Reid R, et al. (2011) Maternal influenza vaccination and effect on influenza virus infection in young infants. Arch Pediatr Adolesc Med 165: 104–111.
    1. Bednarczyk RA, Adjaye-Gbewonyo D, Omer SB (2012) Safety of influenza immunization during pregnancy for the fetus and the neonate. Am J Obstet Gynecol 207: S38–46.
    1. Heinonen OP, Shapiro S, Monson RR, Hartz SC, Rosenberg L, et al. (1973) Immunization during pregnancy against poliomyelitis and influenza in relation to childhood malignancy. Int J Epidemiol 2: 229–235.
    1. Deinard AS, Ogburn P Jr (1981) A/NJ/8/76 influenza vaccination program: effects on maternal health and pregnancy outcome. Am J Obstet Gynecol 140: 240–245.
    1. Munoz FM, Greisinger AJ, Wehmanen OA, Mouzoon ME, Hoyle JC, et al. (2005) Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol 192: 1098–1106.
    1. Marshall V, Gruber M (2012) Influenza immunization during pregnancy: US regulatory perspective. Am J Obstet Gynecol 207: S57–62.
    1. Lin TH, Lin SY, Lin CH, Lin RI, Lin HC, et al. (2012) AdimFlu-S((R)) influenza A (H1N1) vaccine during pregnancy: the Taiwanese Pharmacovigilance Survey. Vaccine 30: 2671–2675.
    1. Zaman K, Roy E, Arifeen SE, Rahman M, Raqib R, et al. (2008) Effectiveness of maternal influenza immunization in mothers and infants. N Engl J Med 359: 1555–1564.
    1. Englund JA, Mbawuike IN, Hammill H, Holleman MC, Baxter BD, et al. (1993) Maternal immunization with influenza or tetanus toxoid vaccine for passive antibody protection in young infants. J Infect Dis 168: 647–656.
    1. Reuman PD, Ayoub EM, Small PA (1987) Effect of passive maternal antibody on influenza illness in children: a prospective study of influenza A in mother-infant pairs. Pediatr Infect Dis J 6: 398–403.
    1. Jackson LA, Patel SM, Swamy GK, Frey SE, Creech CB, et al. (2011) Immunogenicity of an inactivated monovalent 2009 H1N1 influenza vaccine in pregnant women. J Infect Dis 204: 854–863.
    1. Puck JM, Glezen WP, Frank AL, Six HR (1980) Protection of infants from infection with influenza A virus by transplacentally acquired antibody. J Infect Dis 142: 844–849.
    1. Fisher BM, Van Bockern J, Hart J, Lynch AM, Winn VD, et al. (2012) Pandemic influenza A H1N1 2009 infection versus vaccination: a cohort study comparing immune responses in pregnancy. PLoS One 7: e33048.
    1. WHO (2005) Influenza vaccines. Wkly Epidemiol Rec 80: 279–287.
    1. Fiore AE, Uyeki TM, Broder K, Finelli L, Euler GL, et al. (2010) Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 59: 1–62.
    1. ACOG (2004) ACOG committee opinion number 305, November 2004. Influenza vaccination and treatment during pregnancy. Obstet Gynecol 104: 1125–1126.
    1. Mereckiene J, Cotter S, Nicoll A, Levy-Bruhl D, Ferro A, et al... (2008) National seasonal influenza vaccination survey in Europe, 2008. Euro Surveill 13.
    1. WHO (2011) Recommended composition of influenza virus vaccines for use in the 2011–2012 northern hemisphere influenza season. Wkly Epidemiol Rec 86: 86–90.
    1. Adegbola R, Nesin M, Wairagkar N (2012) Immunogenicity and efficacy of influenza immunization during pregnancy: recent and ongoing studies. Am J Obstet Gynecol 207: S28–32.
    1. The European agency for the evaluation of medicinal products (1997) Note for guidance on harmonization of requirements for influenza vaccines. Available: .
    1. ACOG (2010) ACOG Committee Opinion No. 468: Influenza vaccination during pregnancy. Obstet Gynecol 116: 1006–1007.
    1. de Jong JC, Palache AM, Beyer WE, Rimmelzwaan GF, Boon AC, et al. (2003) Haemagglutination-inhibiting antibody to influenza virus. Dev Biol (Basel) 115: 63–73.
    1. Sumaya CV, Gibbs RS (1979) Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: reactogenicity and immunogenicity in mother and infant. J Infect Dis 140: 141–146.
    1. Englund JA (2003) Maternal immunization with inactivated influenza vaccine: rationale and experience. Vaccine 21: 3460–3464.
    1. Steinhoff MC, Omer SB, Roy E, Arifeen SE, Raqib R, et al. (2010) Influenza immunization in pregnancy – antibody responses in mothers and infants. N Engl J Med 362: 1644–1646.
    1. Tsatsaris V, Capitant C, Schmitz T, Chazallon C, Bulifon S, et al. (2011) Maternal immune response and neonatal seroprotection from a single dose of a monovalent nonadjuvanted 2009 influenza A(H1N1) vaccine: a single-group trial. Ann Intern Med 155: 733–741.
    1. Manzoli L, Ioannidis JP, Flacco ME, De Vito C, Villari P (2012) Effectiveness and harms of seasonal and pandemic influenza vaccines in children, adults and elderly: a critical review and re-analysis of 15 meta-analyses. Hum Vaccin Immunother 8: 851–862.

Source: PubMed

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